Why are we not Conceiving?
In order to get pregnant a couple need some sperm, some eggs, functioning uterus and fallopian tubes and sexual intercourse.
Whilst that sounds simple many couples and even doctors get distracted by obscure potential problems in one of these areas, whilst ignoring glaring problems in another.
Steps of Conceiving
In the woman’s head there is a small gland called the pituitary gland. At the beginning of the cycle this gland will start to secrete a hormone called Follicle Stimulating Hormone (FSH), and this will stimulate the ovaries to produce some follicles which contain eggs (oocytes).
By the end of the first week one of these follicles will become dominant and the others will fall away. Usually by day 10 or eleven this follicle will have grown to about 20mm and the egg inside it will be mature.
At the same time as this the follicle is producing the hormone oestrogen, (commonly referred to as E2 by medical staff). This has several functions, but importantly will make the lining of the womb grow ready to receive a fertilised egg.
Around day 13 there is a surge of hormone called Luteinising Hormone (LH) from the pituitary, which causes the follicle to release the egg. This hormone is detectable in the urine and is the basis of home ovulation tests.
The egg will then fall along with 5 to 10 mls. of fluid into a pouch behind the uterus, called the Pouch of Douglas, into which the fallopian tubes are dangling. The tubes contain millions of hairs which beat in time and suck the fluid along with the egg into the tube.
Hopefully the couple will have had intercourse at the right time and sperm will have been deposited onto the cervix. They will have swum up through the cervix and uterus and into the fallopian tubes, where they will meet and fertilise the egg.
The egg will spend two or three days growing in the fallopian tube before being deposited into the uterus and beginning to implant.
As all of these steps need to occur it is therefore not surprising that pregnancy does not happen every time.
Difficulty in Conceiving
So as stated earlier there are four main areas where you might be having difficulty:
Your doctor will take a history and arrange investigations to try and identify the cause.
Fertility Ovulation Problems
If you have regular periods you are usually ovulating. This can be tested at home with a urine test bought from a chemist. Your doctor may also confirm this with a blood test for a hormone called progesterone taken a week after ovulation should have taken place.
Another blood test for hormones may be taken at the beginning of the cycle to try to identify why you might have poor ovulation. These are called Follicle Stimulating Hormone (FSH) and Leutinising Hormone (LH).
Male Fertility Sperm Problems
You may have fathered children previously. In this case it is likely that the sperm count will be normal, but not necessarily so. The doctor will ask you to arrange for a sample to be analysed in the laboratory. Counts vary from day to day in an individual, and a repeat sample will commonly be asked for.
Anatomical problems
An ultrasound examination will usually confirm the shape of your uterus and the quality of the lining of the womb (the endometrium). However further tests are required to check the Fallopian Tubes. This would normally be a simple operation called a laparoscopy or an X-Ray called an HSG.
Sexual Problems and Fertility
The doctor will discuss this with you.
The treatment your doctor recommends will of course depend on the nature of the problem.
Problems Conceiving? Book your appointment today
At IVF Chelsea we can provide a range of services and information, including Fertility Treatments, Laparoscopy Fertility Treatments, advice on Problems Conceiving and common Fertility Problems.
For more information regarding our IVF Treatment in London or to discuss your problems conceiving please Contact us on 01494 892279 or at julian.norman-taylor@chelwest.nhs.uk.
Do you have any tips for conceiving?
How many times have you been advised to relax, and it will happen? Whilst this is true up to a point, it is only possible to not worry about it for so long. In general it is recommended that a couple should wait 12 months before seeking professional advice.
In the meantime it is worth making sure you are as healthy as possible. Ensure that you are taking Folic Acid to reduce the chance of spina bifida in your baby and ensure that you had rubella vaccination as a child.
For more information please see our main FAQ page.
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IVF Chelsea offers fertility treatment closely associated with the Chelsea & Westminster Hospital. We offer personalised care for the management of infertility with a philosophy of providing individualised care for each couple. We are ideally suited to couples in and around Chelsea, Westminster, Brompton,Hammersmith, Kensington, Mayfair, Lambeth, Battersea, Wandsworth, Weybridge and Fulham, but also see couples throughout the UK. Please contact us to see how we can help you today.
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